Reducing Hospital Stay After Surgery

CHARLOTTESVILLE, Va., Feb. 13, 2013 – A
bold new approach that gets people out of the hospital more quickly
after a major cancer surgery is producing excellent outcomes and
reducing costs for patients at the University of Virginia Health
System, a new study shows.

Researchers at UVA set out to evaluate the safety and effectiveness
of a streamlined approach to postoperative care following what is known
as a Whipple procedure. The complex surgery, also known as a
pancreaticoduodenectomy, treats tumors of the pancreas and its
surroundings.

A typical hospital stay for a Whipple procedure is 10 days to two
weeks. The streamlined approach tested at UVA aims to reduce that to
only six days. The clinical trial of the new approach found that median
stay was seven days, with 41 percent of patients out of the hospital by
the sixth day. “This represents the shortest post-operative clinical
pathway that has been described in the medical literature,” says UVA’s
Todd W.
Bauer, MD, who launched the approach and led the
trial.

Recovery time after a procedure is particularly important for patients
with cancer, as it allows them to begin chemotherapy six weeks after
surgery, Bauer notes. “Not only is it important for the patients’
quality of life, this will impact their long-term survival,” he
says.

Keys to Success
The study examined outcomes for 113 patients who underwent a Whipple
procedure using the new clinical pathway. There have been zero deaths
in the seven years since the study began, compared with a reported
mortality rate of 1 percent to 2 percent at many hospitals that perform
the procedure.

Bauer attributes the success of UVA’s approach to several key
factors:

Minimizing blood loss during the procedure and avoiding blood
transfusions

Taking a meticulous approach to the surgery, to prevent
complications

Establishing a clear timeline charting milestones after
surgery

Ensuring all care providers are working in unison

Educating patients on what to expect each day and actively
involving them in their care.

In the wake of the success of the trial, UVA is implementing the new
approach permanently, Bauer says.

“We do a lot of these, and that contributes to our positive outcomes,”
he says of the Whipple procedure. “But our goal is not just to do a lot
of these – it’s to have the best possible outcome for every patient. …
So it has been very rewarding for us to see our patients doing so
well.”